Description of Pressure Ulcers

Pressure ulcers (also known as bedsores) are wounds caused by prolonged pressure on specific parts of the body. They occur in patients with extended immobility, leading to delayed healing, increased pain, and higher costs and time for care.

Common Sites of Occurrence

• Bony prominences: heels, coccyx (tailbone), elbows, shoulder blades, occiput
• Other areas: ankles, greater trochanter, ribs, acromion, ears
• Special regions: toes, knees, male genitalia, female breasts, cheekbones, chin

Risk factors: friction during repositioning, moisture from incontinence or sweating.

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Stages of Pressure Ulcers

1. Stage I

   • Redness on intact skin, with no pressure residue
   • Indicators: warmth, swelling, hardness (particularly in darker skin)

2. Stage II

   • Partial-thickness skin loss (epidermis, dermis, or both)
   • Surface-level ulcer appearing as an abrasion or blister

3. Stage III

   • Full-thickness skin loss
   • Necrosis of underlying tissues without tunneling

4. Stage IV

   • Extensive tissue necrosis, involving muscle or bone
   • Formation of a deep cavity (tunneling)

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Prevention and Care

• Regular skin inspection: at least three times a day (use gloves)
• Repositioning: every 2 hours (supine, right/left lateral)
• Weight shifting: gentle movements every 30 minutes in bed
• Limit semi‑sitting: no more than 30 minutes at a time
• Gentle massage: around reddened areas every 2 hours
• Alternating‑pressure mattresses
• Perfusion monitoring: ensure dressings are not too tight
• Linens: keep sheets dry and smooth
• Incontinence catheter use
• Adequate hydration of the patient
• Cleansing with neutral soap: codes 125939, 100472
• Moisturizing lotion: thin layer once daily (codes 100474, 100477, 100476)
• Keep skin clean and dry
• Protect from wound exudate and urine/feces: immediate removal, use of urine collector
• Physical activity: active/passive movements and local massages
• Edema management: medical/nursing evaluation
• Itch relief: cold compresses, antihistamines, trimmed nails
• Nutrition: rich in proteins, vitamins, and trace elements

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High‑Pressure Points by Position

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Treatment of Pressure Ulcers

1. Ulcer assessment
2. Thorough cleansing of the affected area
3. Pressure offloading at the ulcer site

For evaluation and home nursing care, contact us.